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NPI Code Detail

MEDICARE: DIANE C. MARIN OTR

MEDICARE:   DIANE C. MARIN  OTR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist121428TX

General Provider Information

NPI Number : 1336733930
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANE C. MARIN OTR
Provider Business Mailing Address
First Line : 10300 S INTERSTATE 35 FRONTAGE RD
Second Line : APT 2202
City : AUSTIN
State : TX
Zip : 78748
Country : US
Telephone Number : 646-474-3241
Fax Number :
Provider Business Practice Location Address
First Line : 10300 S INTERSTATE 35 FRONTAGE RD
Second Line : APT 2202
City : AUSTIN
State : TX
Zip : 78748-7874
Country : US
Telephone Number : 646-474-3241
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2021
Last Update Date : 02/24/2021

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Directions to “ DIANE C. MARIN OTR” Practice Location

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